Active NPI
Shannon Christina Boyer, NP
- Nurse Practitioner
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 18967A
- Practice address
- 777 N Raymond St
Boise, ID 83704-9251 - Phone
- (208) 367-6030
- Fax
- (208) 322-7018
- NPI assigned
- Jun 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18967A | ID | Primary |
Addresses
Primary practice location
777 N Raymond St
Boise, ID 83704-9251
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 367-6030
Other names 1
- Shannon Christina Bolster
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 N Robbins Rd
Boise, ID 83702-4565
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
- Saint Alphonsus Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18967A | ID | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Family Medicine | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Family Medicine | Current | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
Interoperability endpoints
- sboyer37531@direct.slhs.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214179200000",
"number": "1770744609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-367-6030",
"fax_number": "208-322-7018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-367-6030",
"fax_number": "208-322-7018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYER",
"first_name": "SHANNON",
"middle_name": "CHRISTINA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2008-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "18967A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "BOLSTER",
"middle_name": "CHRISTINA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.